Scientists seek origins of obesity in the womb

NEW YORK 
When Kathy Perusse had weight-loss surgery and shed 120 pounds, she may have done more than make her own life easier.

She went on to have two daughters, and she may have boosted their chances of avoiding becoming obese, like her two older children are.

That's the implication of research suggesting that something in an obese woman's womb can program her fetus toward becoming a fat child and adult. It's not about simply passing along genes that promote obesity; it's some sort of still-mysterious signal.

The idea has only recently entered conversations between doctors and female patients, and scientists are scrambling to track down a biological explanation. That knowledge, in turn, may provide new ways to block obesity from crossing generations.

While there's some disagreement on how important the womb signal is, "the evidence is building and building that it is a substantial issue," said Dr. Matthew Gillman of Harvard Medical School, who studies prevention of obesity.

Others agree. "I think it could be a hugely significant factor," said Robert Waterland of the Baylor College of Medicine in Houston, who studies the effect in mice.

Dr. Rudy Leibel, an obesity expert at Columbia University, says he doubts it plays a huge role, but still believes it's worth studying. If scientists can uncover its biological underpinnings, he said, they may be able to use that knowledge to prevent or treat obesity from other causes.

Perusse, 39, of Three Rivers, Quebec, knows the effects of being very fat. Before her weight-loss surgery in 1995, she packed 284 pounds on her 5-foot-2 frame. She could not ride a bike or climb stairs to her second-floor home without stopping to rest.

Now, although she's still overweight, those limitations are history, she said through an interpreter.

But her older children struggle with their weight. At 5-foot-3 and 300 pounds, her 22-year-old daughter can't bathe her own two children, Perusse said. Her 16-year-old son weighs 230 pounds and stands 5-foot-6.

They were born before she had the weight-loss surgery. Her two younger daughters, ages 4 and 7, came along afterward. Their weights are normal so far, though Perusse said her older children weren't overweight at those ages either.

So she's using diet and exercise to try to protect them against what she called rotten genes, including those from their 400-pound father. She said she isn't optimistic.

But Dr. John Kral of the SUNY Downstate Medical Center in New York says his research suggests that obese women who lose weight before pregnancy may be helping the next generation keep off excess pounds – even if fat-promoting genes run in the family.

With researchers at Laval Hospital in Quebec, Kral has studied children of severely obese women who were born before or after their mother's weight-loss surgery. They found that, in comparison to children born before surgery, those born afterward were far less likely to be severely obese.

In addition, those born afterward showed lower levels of blood fats and indicators of future diabetes.